Significance: Of the 4 million babies born in the US each year, 120,000 (3%) have a complex birth defect. Some defects, such as spina bifida, warrant in utero interventions to improve fetal outcomes. Spina bifida is a condition where there is incomplete closing of the backbone and membranes around the spinal cord. Texas Children?s Hospital has pioneered a fetoscopic method to address spina bifida. While much of the surgery can be performed through ports, the uterus currently needs to be exteriorized in order to position the fetus appropriately and place sutures to anchor the chorioamniotic membranes to the uterine wall. The sutures are placed to prevent preterm premature rupture of membranes (pPROM) which leads to both maternal and fetal complications. PPROM is a common complication of fetal surgery, occurring in about 30% of minimally invasive cases. The risk of pPROM, both maternal and fetal, often offsets the benefits of fetal treatment. Innovation: The Uterine wall-Membrane Anchor (UMA) is a linear device that facilitates the percutaneous suturing of chorioamniotic membranes to the uterine wall during fetoscopic surgery. Two cylindrical anchors are deployed on either side of the uterine wall and connected by a knotted suture that can be tightened to secure the membranes. This solution facilitates the conversion of existing open fetal procedures to percutaneous procedures and potentially the development of new fetal interventions. Approach: In this SBIR Phase I project, Fannin Innovation Studio will optimize the prototype device design and test it in benchtop and animal models. Aim 1 is focused on refining and optimizing the UMA prototype and developing the surgical procedure to deploy the device. This will accelerate our progress towards clinical implementation and commercialization. In Aim 2, the optimized prototype developed in Aim 1 will be tested in pregnant rabbit chronic studies and pregnant sheep acute studies. We believe that the UMA device will bring value to patients, doctors, and children?s hospitals by providing a solution that reduces maternal and fetal complications, expands patient population through the development of a safer percutaneous procedure, and leads to better outcomes for children with spina bifida.